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PubMed2002

Does the histological subtype of high-grade central osteosarcoma influence the response to treatment with chemotherapy and does it affect overall survival? A study on 570 patients of two consecutive trials of the European Osteosarcoma Intergroup.

Large randomised trials are mandatory when one wants to examine the effects of different aspects (such as the treatment modality) of a pathological condition on the overall outcome. This is especially true when studying a disease in which there is a multifactorial influence on progression and outcome such as osteosarcoma. Data on 570 patients with biopsy-proven primary central osteosarcoma of an extremity included in two consecutive studies of the European Osteosarcoma Intergroup (EOI) were analysed in order to evaluate if the histological subtype of the biopsy specimen correlated with the subtype of osteosarcoma represented in the resected specimen, if there was a relationship between the histological subtype and overall survival and if there was a relationship between the histological subtype and histological response to chemotherapy. High-grade osteosarcoma, as defined by established criteria, was subtyped as either conventional, chondroblastic, teleangiectatic, small cell, fibroblastic, osteoclast rich, anaplastic and sclerotic/osteoblastic well differentiated. A panel of experienced pathologists with a special interest in bone pathology was appointed to review the histological diagnosis and to assess the tumour response to chemotherapy on the resected specimen of each patient entered into the trials. Subtyping on the biopsy specimen proved to be highly representative for the subtype of the whole tumour. In 102 patients for which subtyping was performed on the biopsy and the resected specimens, there were only two discrepancies. Of the 568 patients for whom subtype was available, 404 (71%) were of the conventional type, 54 (10%) were chondroblastic, 53 (9%) had fibroblastic tumours and the remainder consisted of rare subtypes. A good response to preoperative chemotherapy was defined as 90% or more necrosis. The proportion of patients responding well to chemotherapy differed significantly between subtypes (Chi-square test statistics=11.44, P=0.01 on 3 degrees of freedom (d.f.)). In comparison with the conventional subtype, there was a higher proportion of good responders in the fibroblastic group and a lower proportion of good responders in the chondroblastic group. Good responders had a significantly better survival than patients who responded poorly to the pre-operative chemotherapy (logrank statistic=25.20, P<0.01 on 1 df). Survival did not differ significantly according to subtype (logrank statistic=2.72, P=0.44 on 3 df), although there was a suggestion that patients with chondroblastic tumours experienced a better long-term survival. This large set of prospectively-collected data provides important information on the relationship between pathological subtype, histological response and survival. Histological response has a known prognostic effect on survival, and we have shown that the rates of response differ by subtype. There is some evidence from this study that the specific histological subtypes, i.e. the chondroblastic subtype, experience better survival. However, despite this large multi-institutional study, we have insufficient numbers of non-conventional tumours to examine this unambiguously for these subsets.

Adolescent↗
PubMed1998

Cancer of the corpus uteri in white and black women in Michigan, 1985-1994: an analysis of trends in incidence and mortality and their relation to histologic subtype and stage.

BACKGROUND: Cancer of the corpus uteri occurs more commonly among white women in the U.S., yet survival is poorer for black women. This study examined whether this trend has changed and also examined the relation of age and histologic subtype to differences in stage. METHODS: This retrospective cohort study assessed incidence trends, mortality trends, and the relation of age and histologic subtype to stage for 12,079 incident cases and 2325 deaths registered between 1985 and 1994 in Michigan. Rate ratios compared incidence and mortality. Odds ratios quantified the contribution of age and histologic subtype to differences in risk for advanced stage, using Mantel-Haenszel univariate techniques and multivariate logistic regression. RESULTS: The overall incidence rate was 21.99 per 100,000, and the overall mortality rate was 3.82 per 100,000. Black women had a 40% lower risk (rate ratio [RR] =0.60) of developing cancer of the corpus uteri but had a 54% greater risk (RR=1.54) of dying from cancer of the corpus uteri. Black women were at greater risk of being diagnosed with either sarcoma or more aggressive adenocarcinoma. However, after adjustment for age and histologic subtype, black women still had an increased risk for advanced stage disease (2.63, 95% confidence interval=2.19-3.16). CONCLUSIONS: The disparity between white and black women persists in incidence and mortality trends for cancer of the corpus uteri. The greater frequency of more aggressive histologic subtypes experienced by black women accounts for only 10% of their excess risk for more advanced stage disease.

Adenocarcinoma↗
PubMed1998

Prognosis in malignant mesothelioma related to MIB 1 proliferation index and histological subtype.

The aims of this study were to evaluate the use of the proliferation marker MIB 1 and histological subtype as indicators of prognosis in malignant mesothelioma. Sections from 41 cases of malignant mesothelioma were histologically subtyped on hematoxylin and eosin sections and stained immunohistochemically for the proliferation marker MIB 1. A proliferation index was derived and the results compared with patient survival data. A statistically significant difference was found between the survival of patients having a low and high MIB 1 index (P < .001). Patients with tumors having a low MIB 1 index lived significantly longer than those with a high MIB 1 index. Patients with the spindle cell histological subtype of malignant mesothelioma had significantly shorter survival times than those with the epithelioid or mixed tumors (P < .01). The MIB 1 proliferation index and histological tumor subtype are useful markers of prognosis in malignant mesothelioma.

Antibodies, Monoclonal↗
PubMed2007

Prognostic significance of a histologic subtype in small adenocarcinoma of the lung: the impact of nonbronchioloalveolar carcinoma components.

BACKGROUND: We tried to clarify whether the histologic subtypes and the size of the solid component of an adenocarcinoma are more important predictive factors for invasiveness or prognosis than is total tumor size, even in lung adenocarcinomas that were 2 cm or smaller. METHODS: Between 1996 and December 2005, after standard surgical treatment, 82 patients were diagnosed as having adenocarcinoma with a maximum diameter of 2 cm or less. The group comprised 37 females and 45 males, with ages ranging from 41 to 80 years (median, 64). The clinicopathologic records of the patients were examined with regard to age, sex, nodal status, tumor size (largest diameter of the total tumor as well as the largest diameter without the bronchioloalveolar carcinoma [BAC] component [solid component]), serum carcinoembryonic antigen level, and histologic type. These variables were analyzed as risk factors for vascular or lymphatic invasion, lymph node metastasis, and prognosis. Histologic subtype was classified into two groups: mixed BAC (mixed adenocarcinoma with BAC) and minimal or non-BAC (tumors with little or no BAC component). RESULTS: Histologic subtype was a significant predictive factor both for invasiveness (vascular or lymph vessels) and lymph node metastasis, in both univariate and multivariate analysis. Tumor diameter was not a significant factor in either univariate or multivariate analysis (p = 0.28, 0.15, respectively). However, diameter excluding the BAC component was a significant factor for invasiveness in mixed BAC type (p = 0.035), whereas total diameter was not significant (p = 0.28). Finally, histologic subtype and lymph node metastasis were significant prognostic factors for survival in both univariate (p = 0.03, 0.05, respectively) and multivariate (p = 0.04, 0.05, respectively) analyses. The 5-year survival rate was 94.4% (94.1% for pN0) for the mixed BAC type and 71.4% (78.7% for pN0) for the minimal or non-BAC type (p = 0.009; p = 0.04 for pN0 nodes). CONCLUSIONS: Small adenocarcinomas can be classified into two categories. The first category is a minimal or non-BAC adenocarcinoma that shows aggressive biological behavior. The second category is a mixed BAC, which demonstrates less invasive or aggressive biological behavior than the minimal or non-BAC type, with the degree of invasiveness being associated with the size of the non-BAC component.

Adenocarcinoma↗
PubMed2006

Image cytometry DNA ploidy correlates with histological subtypes in endometrial carcinomas.

Image cytometric DNA ploidy analysis of endometrial carcinomas was performed to determine whether ploidy status and ploidy-related parameters like DNA index, percentage of cells exceeding 5c and 9c, correlate with histologic subtype. This is a prospective study of 391 patients with stage I endometrial carcinoma which included 331 (85%) endometrioid adenocarcinoma, 22 (6%) serous adenocarcinoma, 7 (2%) clear cell adenocarcinoma, 2 (0.5%) small cell carcinoma, 1 (0.3%) undifferentiated carcinoma, and 28 (7%) unclassifiable adenocarcinoma. Twenty-five percent of endometrioid adenocarcinomas were non-diploid. In contrast, all clear cell adenocarcinomas and 21/22 (95%) of serous adenocarcinomas were non-diploid. Hyperdiploidy (25 cases) was found only in endometrioid adenocarcinomas. Mean DNA index of the stemline in serous adenocarcinoma (1.72) and clear cell adenocarcinoma (1.81) was higher than in endometrioid adenocarcinoma (1.1). The difference in ploidy-related parameters between endometrioid adenocarcinoma and serous adenocarcinoma was highly significant (P<0.001). In addition, Grade 3 endometrioid adenocarcinoma showed significant difference in all ploidy-related parameters compared with grade 1 and grade 2 tumors (P<0.001). Our results show that DNA ploidy-related parameters may be valuable in subtyping histologically difficult cases of endometrial carcinomas.

Adenocarcinoma↗
PubMed1983

Mortality among children with rhabdomyosarcomas of the alveolar histologic subtype.

Of 116 patients with rhabdomyosarcoma of the alveolar histologic subtype who entered the Intergroup Rhabdomyosarcoma Study (IRS) from 1972 to 1978, there were 72 deaths (63%), compared with a mortality of 39% among patients with all nonalveolar types combined. The subgroup with alveolar histology contributed greater than 29% of the total mortality, although it represented 20% of the total patients (p less than .001). This recurrence rate reflects increased local, regional, and distant relapse. Differences were most marked in patients with grossly excised tumors (clinical groups I and II) in which the mortality was 44% in patients with alveolar tumors (48 patients) versus 13.5% in those with embryonal histology (111 patients), and 16% in all patients with nonalveolar tumor types. When survival was influenced by primary tumor site this reflected, in most body areas, an increase in the proportion of patients with the alveolar histology in that site. Patients with unresected or disseminated tumors (clinical groups III and IV) of the alveolar subtype have initial response rates to VAC and radiotherapy which are similar to those of patients with tumors of other cell subtypes (70% for group III and 50% for group IV). In these clinical groups, the differences in survival related to histologic subtype are not significant. The presence of the alveolar histologic subtype represents a rational basis for employing more intensive therapy in the management of patients with rhabdomyosarcomas.

Adolescent↗
PubMed1992

Outcome of conservative therapy for invasive breast cancer by histologic subtype.

Between 1977 and 1986, 879 patients with Stage I and II breast cancer underwent excisional biopsy, axillary dissection, and radiation. Median follow-up was 61 months (range 2-159 months). The patients were divided into seven groups based on histologic subtype: (a) 368 patients with both infiltrating and intraductal ductal carcinoma, (b) 389 infiltrating ductal carcinoma, (c) 41 infiltrating lobular carcinoma, (d) 23 combined infiltrating ductal and lobular carcinoma, (e) 28 medullary carcinoma, (f) 12 colloid carcinomas, and (g) 18 tubular carcinomas. Significant differences in clinical T status, pathologic nodal involvement, administration of chemotherapy, estrogen receptor positivity, progesterone receptor positivity, and age were observed between some histologic subgroups. Tubular and colloid carcinomas were more likely to present with T1 lesions, hormone receptor positivity, and node negative status than the other histologic subtypes. Most medullary carcinomas were hormone receptor negative and were younger than 50 years old. Infiltrating lobular carcinoma patients were more frequently lymph node negative, older, node negative, and estrogen receptor positive compared to the other groups (except for tubular and colloid patients). Differences in the administration of chemotherapy primarily reflected differences in lymph node involvement. Location of the tumor in the breast and menopausal status did not correlate with histologic subtype. There were no significant differences in 5-year actuarial overall survival, cause-specific survival, or relapse-free survival between the histologic categories. In addition, patterns of first failure were not significantly different among the histologic groups in terms of local-only first failure, any local component of first failure, regional-only first failure, or any regional component of first failure. There was, however, a difference among the seven groups in distant metastasis-only at first failure with invasive ductal carcinomas having the highest rate. Despite this difference, histologic subtype had no impact on survival. The site of in-breast failure relative to the location of the original tumor was not significantly different between groups. The histologic subtype of invasive breast cancer is not an independent risk factor in predicting survival or pattern of failure. Conservative surgery and radiation therapy is effective treatment of ductal, lobular, medullary, colloid, and tubular invasive breast cancer.

Adenocarcinoma↗
PubMed2005

Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience.

PURPOSE: To analyze to what extent histologic subtype is of prognostic importance in renal cell carcinoma based on a large, international, multicenter experience. PATIENTS AND METHODS: Four thousand sixty-three patients from eight international centers were included in this retrospective study. Histologic subtype (1997 International Union Against Cancer [UICC] criteria of tumor response), age, sex, TNM stage, Fuhrman grade, tumor size, Eastern Cooperative Oncology Goup performance status (ECOG PS), and overall survival were determined in all cases. The prognostic values of clear cell, papillary, and chromophobe histologic features were assessed by uni- and multivariate analysis using the Kaplan-Meier method and Cox model, respectively. RESULTS: Clear cell, papillary, and chromophobe carcinomas accounted for 3,564 (87.7%), 396 (9.7%) and 103 (2.5%) cases, respectively. In univariate analysis, a trend toward a better survival was observed when clear cell, papillary, and chromophobe histologies were considered prognostic categories (log-rank P = .0007). However, in multivariate analysis, TNM stage, Fuhrman grade and ECOG PS, but not histology, were retained as independent prognostic variables (P < .001). CONCLUSION: The stratification in three main renal cell carcinoma histologic subtypes as defined by the 1997 UICC-American Joint Committee on Cancer consensus should not be considered a major prognostic variable comparable to TNM stage, Fuhrman grade and ECOG PS.

Adolescent↗
PubMed2004

KI-67 antigen expression predicts survival and correlates with histologic subtype in the WHO classification of thymic epithelial tumors.

We performed an immunohistochemical study with monoclonal antibodies to Ki-67 antigen and p53 protein on 45 cases of thymic epithelial tumors classified according to the recent World Health Organization (WHO) classification system to evaluate whether there is correlation between the expression of these markers and prognosis, histologic subtype, and myasthenia gravis (MG). We also correlated histologic subtype with sex, age, MG, and survival. Ki-67 and p53 labeling indices (LIs) were expressed as a percentage of positive nuclear immunostaining by counting 1,000 epithelial tumor cells. Statistically significant differences were found between Ki-67 LI and survival (p = 0.007), whereas the prognostic implication of p53 could not be demonstrated, although there appeared a trend that patients with tumors of higher LIs had worse survival. Significant correlations were also found between Ki-67 (p < 0.0005) and p53 (p < 0.0005) LIs and histologic subtypes. No correlation was found between these parameters and MG. Histologic subtypes of the WHO classification also correlated with survival (p = 0.01), whereas no correlation was found with sex, age, and MG. In conclusion, our results indicate that the proliferative activity, assessed by Ki-67 LI, and the histologic pattern, according to WHO classification system, seems to represent reliable parameters in the prognosis of thymic epithelial tumors.

Adult↗
PubMed2004

The histologic subtype of ovarian tumors affects the detection rate by pelvic washings.

BACKGROUND: Since its introduction more than 45 years ago, the pelvic wash has gained widespread acceptance and is used routinely use at most centers. However, widely varying figures have been reported regarding its sensitivity for peritoneal involvement in ovarian tumors. In the current study, the authors evaluated a consecutive group of pelvic (peritoneal or abdominopelvic) washings performed in the evaluation of adnexal masses to determine whether histologic subtype significantly affects the tumor detection rate using this procedure. METHODS: Reports from all washes performed over a 5-year period in the evaluation of adnexal masses were evaluated and correlated with those of the synchronously obtained histologic specimens. The sensitivity for each histologic subtype was calculated, with ovarian surface involvement and/or tumoral involvement of any peritoneal surface defined as the criterion standard. Cases with cytologic and histologic concordance were defined as true-positive or true-negative. Statistical significance was determined using the Fisher exact test. RESULTS: In the current study, 185 of 846 (21.9%) total washes were associated with malignant (n = 161) or borderline (n = 24) tumors involving the ovary. For the malignancies, the overall cytology detection rate was 25%. A comparison of the cytology detection rates for the individual histologic subtypes with the overall rate demonstrated that the serous carcinomas were more likely (P = 0.0144) and the clear cell carcinomas were less likely (P = 0.0452) to be detected in pelvic washings. Cytology detection rates for mucinous, endometrioid, and undifferentiated carcinomas did not appear to differ significantly (P > 0.05) from the average detection rate. The cytohistologic correlation rate (efficiency), sensitivity, and specificity for the 5 most common histologic subtypes (n = 130) were 79.23%, 50.77%, and 93.33%, respectively. Differences also were observed in the calculated sensitivity for each subtype: serous (n = 57), 71.4%; endometrioid (n = 30), 58.33%; clear cell (n = 19), 20%; mucinous (n = 13), 50%; and undifferentiated (n = 11), 50%. Borderline tumors demonstrated a sensitivity and specificity of 80% and 100%, respectively. CONCLUSIONS: In the current study, the pelvic wash was found to be a specific, but only moderately sensitive, technique for detecting peritoneal involvement in ovarian tumors. The histologic subtype of the underlying ovarian tumor was found to have an effect on the likelihood of detection of peritoneal involvement using this diagnostic assay.

Adenocarcinoma, Clear Cell↗
PubMed2004

Long-term survival of patients with unilateral sporadic multifocal renal cell carcinoma according to histologic subtype compared with patients with solitary tumors after radical nephrectomy.

OBJECTIVES: To determine the pathologic features, including histologic subtype and tumor size, associated with multifocal renal cell carcinoma (RCC) and the impact of multifocality on survival after radical nephrectomy, about which controversy exists. METHODS: We studied 2373 patients who underwent radical nephrectomy for RCC from 1970 to 2000. Histologic subtype, stage (2003 TNM), nuclear grade, tumor size, and multifocality, defined as the presence of more than one ipsilateral RCC tumor of the same histologic subtype, were evaluated. Associations of multifocality with ipsilateral and contralateral recurrence and death from RCC were evaluated using Cox proportional hazards models. RESULTS: The incidence of sporadic histologically concordant multifocality was greater in papillary RCC (29 of 266; 10.9%) compared with clear cell RCC (40 of 1934; 2.0%; P <0.001) and chromophobe RCC (2 of 104; 1.9%; P = 0.005). Patients with solitary clear cell and papillary RCC had larger tumors compared with multifocal clear cell and papillary RCC (P <0.001 and P = 0.024, respectively). Patients with multifocal clear cell RCC were more likely to have a contralateral recurrence than were patients with solitary clear cell RCC (risk ratio 2.91, P = 0.142). Multifocality was not significantly associated with ipsilateral recurrence or death from RCC in patients with clear cell or papillary RCC. CONCLUSIONS: The incidence of multifocality was significantly greater among patients with papillary RCC than among patients with clear cell or chromophobe RCC. Patients with multifocal clear cell RCC were more likely to experience a contralateral recurrence. Multifocality was not significantly associated with ipsilateral recurrence or death from RCC. In addition, multifocality was not associated with larger and higher stage tumors, as previously reported.

Adenocarcinoma↗
PubMed1996

Expression of EBER1 in primary and metastatic nasopharyngeal carcinoma tissues using in situ hybridization. A correlation with WHO histologic subtypes.

BACKGROUND: The association of Epstein-Barr virus (EBV) with nasopharyngeal carcinoma (NPC) is well documented. Previous studies reported abundant expression of EBER1 in primary NPC and tumors metastatic to lymph nodes. However, a large series of case studies correlating World Health Organization (WHO) histologic subtypes with EBER1 is needed. METHODS: The authors applied the EBER1 in situ hybridization to investigate the expression of EBER1 in 140 primary NPCs, 11 metastatic tumors to lymph nodes, 6 metastatic tumors to bone marrow, and 2 metastatic tumors to the liver. All 19 metastatic tumors had paired specimens from their primary NPCs for comparison. The in situ hybridization method was performed on paraffin embedded tissues by using polymerase chain reaction-derived, digoxigenin-labelled EBER1 DNA probes. RESULTS: The EBER1 signal was identified in nuclei of malignant epithelial cells in 135 of 140 (96.4%) primary NPCs, including 4 of 5 (80%) WHO-I histologic subtypes, 71 of 73 (97.3%) WHO-II histologic subtypes, and 60 of 62 (96.8%) WHO-III histologic subtypes (P > 0.05). However, the positive hybridization signal in WHO-I NPC was less in proportion to malignant cells, usually limited to basal cells, than in other histologic types of NPC. In 10 of 11 specimens with metastases to the lymph nodes, hybridization was always limited to the malignant cells and not associated with lymphocytes. All 10 paired primary NPCs also demonstrated positive EBER1 hybridization. Only one paired specimen showed negative EBER1 in primary NPC and a metastases to a lymph node. Eight distant metastases, all EBER1-positive in their primary NPC, also demonstrated positive EBER1 hybridization signals in the malignant cells. The proportion of EBER1 positivity in metastatic NPC is higher than that in primary lesions as observed in paired specimens from the same patient. CONCLUSIONS: Because of abundant expression of EBER1 in primary NPC as well as in metastatic malignant cells, it is recommended that EBER1 in situ hybridization be performed on routinely processed specimens whenever NPC is suspected.

Base Sequence↗
PubMed1991

Flow cytometric DNA content analysis in neuroendocrine carcinoma of the lung. Correlation with survival and histologic subtype.

The DNA content of 53 primary and locally metastatic pulmonary neuroendocrine carcinomas was retrospectively determined by flow cytometric analysis of nuclei released from paraffin-embedded tissues and compared with histologic subtypes and clinical survival. Forty-one percent (9 of 22) of tumors classified as well-differentiated neuroendocrine carcinoma (WDNC) were aneuploid. In contrast, 85% (17 of 20) of small cell neuroendocrine carcinoma (SCNC), and 73% (8 of 11) of intermediate cell neuroendocrine carcinoma (ICNC) were aneuploid. DNA content was not a significant independent predictor of patient survival within each histologic subtype (P greater than 0.05 for all subtypes). Yet, when all cases were examined as a single group, diploid cases showed better clinical survival than cases with DNA aneuploidy (P less than 0.02). However, the survival advantage for diploid DNA content did not quite achieve statistical significance when only cases of limited stage disease were analyzed (0.10 greater than P greater than 0.05). Histologic subtype was also a prognostic indicator, with WDNC cases showing a significantly longer survival than either SCNC (P less than 0.05) or ICNC (P less than 0.02), for those cases with limited-stage disease. These results indicate information on clinical staging and the histologic subtype are important parameters to compare with DNA content analysis in determining independent prognostic factors in neuroendocrine or small cell carcinoma of the lung.

Adult↗
PubMed2006

Activation of Wnt/beta-catenin signaling in distinct histologic subtypes of human germ cell tumors.

The molecular signaling pathways mediating human germ cell tumor (GCT) formation and progression are poorly understood despite a large number of studies detailing recurrent cytogenetic abnormalities. Germ cell tumors consist of multiple histologic subtypes and can also be divided into infantile/childhood or adolescent/adult tumors as well as gonadal or nongonadal sites of origin. All of these parameters are important in defining clinical outcome and in understanding the pathogenesis of these tumors. We utilized complementary DNA (cDNA) microarray analysis to identify differences in signal transduction pathways between 2 histologic subtypes of malignant ovarian GCTs (dysgerminomas versus ovarian endodermal sinus tumors). Hierarchical cluster analysis using only the genes involved in Wnt/beta-catenin signaling was able to distinguish these 2 tumor subtypes from each other. Wnt13 and beta-catenin showed significant differential expression patterns between the 2 tumor subtypes, and the results were confirmed by semiquantitative reverse transcriptase-polymerase chain reaction. Additional GCTs were studied for the expression of other members of Wnt/beta-catenin signaling, including Wnt13, frizzled, disheveled, low-density lipoprotein receptor-related protein 6, and beta-catenin. Differential expression levels were identified for several histologic subtypes of human GCTs. Finally, we prepared tissue microarrays containing GCTs from 83 different patients and demonstrated high levels of beta-catenin protein expression in 100% and nuclear accumulation in approximately 50% to 70% of all endodermal sinus tumors and immature teratomas (ITs). This pattern was independent of the patient's age. No nuclear accumulation of beta-catenin was observed in germinomas, embryonal carcinomas, or choriocarcinomas. These results indicate that activation of Wnt/beta-catenin signaling plays an important role in the pathogenesis of 2 histologic subtypes of human GCTs.

Adolescent↗
PubMed1990

Analysis of stomach cancer incidence by histologic subtypes based on a mathematical model of multistage cancer induction and exponential growth.

A mathematical model incorporating the processes of both cancer induction and subsequent tumor growth has been developed. The model was applied to incidence data of stomach classified into histologic subtypes: papillary adenocarcinoma (PAP), well and moderately differentiated tubular adenocarcinomas (WEL and MOD), poorly differentiated adenocarcinoma (POR), mucinous adenocarcinoma (MUC) and signet-ring cell carcinoma (SIG). The multistage theory was assumed for cancer induction as in the Armitage-Doll model. For the period of growth, exponential growth was assumed and clinical surfacing was formulated as a stochastic process related to tumor diameter. The number of stages in cancer induction and the tumor growth rate were simultaneously estimated for each histologic subtype using the maximum likelihood procedure. The present model showed better fits than the Armitage-Doll model in most histologic subtypes except WEL, PAP, WEL and MOD, which are characterized as differentiated subtypes with less mucous production, showed different features from POR, MUC and SIG: 1) the number of stages was estimated to be larger, 2) the differences in incidence rates between males and females were more marked, and 3) males tended to have larger growth rates in PAP and MOD, while in POR, MUC and SIG, females had larger values. The present study showed that an analysis by histologic subtypes is of importance in stomach cancer and that the period of tumor growth should not be ignored when formulating a model of the natural history of stomach cancer.

Adenocarcinoma↗
PubMed1975

Histological subtypes and prognostic problems in meningiomas.

The incidence of the various histological subtypes of meningiomas was examined in 1238 patients with surgically treated meningiomas, about 80% arising within the cranial cavity. The histological classification used was that of Courville (1950) and Rubinstein (1972), but "angioblastic" meningiomas were segregated into 3 groups: highly vascularized meningiomas, hemangioblastomas, and hemangiopericytomas. Endotheliomatous and transitional forms constituted 85% of the total (71.5% of intracranial tumors), fibroblastic forms 6.6 and 7.5%, respectively, and highly vascularized (endotheliomatous or transitional) meningiomas 5.2% of the intracranial tumors, while true "angioblastic" meningiomas (hemangioblastomas and hemangiopericytomas) amounted to 2.8% of the total (3.1% of the intracranial tumors). 1.2% were "atypical" (so-called malignant) meningiomas; true meningeal sarcomas were excluded. The incidence of recurrence in patients surviving at least 5 years after apparently complete removal of the tumor was 13% for all sites, and 14.2% for intracranial tumors, but almost twice as high after partial removal. There were no significant differences in the recurrence rate and intervals between first and second operation according to the various histological subtypes of meningiomas, except for hemangiopericytomas which recurred with significantly higher frequency and, together with atypical meningiomas, at much shorter intervals than the others. The prognostic significance of some histological criteria in "non-angiomatous" meningiomas was examined in 211 patients surviving at least 5 years after apparently complete removal of the tumor. Among the recurrences, there was a significantly higher degree of cellularity and increased mitotic rate and, probably, of cortical invasion, while nuclear pleomorphism, increased vascularity, and focal necroses showed no definite differences. The presence of mitotic figures alone appeared to be of no prognostic value. While most recurrent meningiomas did not change their basic morphological type significantly, about 12.5% of the recurrences appeared to have a different rate of growth as suggested by increased cellularity and mitotic rates. In 2 cases an isomorphic (benign) meningioma became a true spindle cell sarcoma.

Adult↗
PubMed2005

Histologic subtypes and laterality of primary epithelial ovarian tumors.

OBJECTIVES: To determine if the likelihood of bilateral primary ovarian tumors differs by histologic subtype. METHODS: Using data collected by the Surveillance Epidemiology and End Results (SEER) program, the analysis included 22,328 women 25-84 years of age who were diagnosed with a borderline or malignant epithelial ovarian tumor during 1992-2000, categorized as to laterality and histologic subtype. RESULTS: Malignant serous tumors were bilateral in 57.5% of cases. Corresponding figures for mucinous, clear cell, endometrioid and other epithelial tumors were 21.3%, 13.3%, 26.8%, and 35.6%, respectively. Borderline serous tumors were bilateral in 29.8% of the cases compared to only 7.0% of mucinous tumors. The tendency for serous tumors to present as bilateral was consistent across all categories of race, age, and stage. CONCLUSIONS: Serous tumors of the ovary are more commonly bilateral than ovarian tumors of other histologic subtypes. The reasons for this tendency remain to be determined.

Adult↗
PubMed2003

Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma.

Our objective was to compare cancer-specific survival and to examine associations with outcome among the histologic subtypes of renal cell carcinoma (RCC). We studied 2385 patients whose first surgery between 1970 and 2000 was a radical nephrectomy for sporadic, unilateral RCC. All RCC tumors were classified following the 1997 Union Internationale Contre le Cancer and American Joint Committee on Cancer guidelines. There were 1985 (83.2%) patients with clear cell, 270 (11.3%) with papillary, 102 (4.3%) with chromophobe, 6 (0.3%) with collecting duct, 5 (0.3%) with purely sarcomatoid RCC and no underlying histologic subtype, and 17 (0.7%) with RCC, not otherwise specified. Cancer-specific survival rates at 5 years for patients with clear cell, papillary, and chromophobe RCC were 68.9%, 87.4%, and 86.7%, respectively. Patients with clear cell RCC had a poorer prognosis compared with patients with papillary and chromophobe RCC (p <0.001). This difference in outcome was observed even after stratifying by 1997 tumor stage and nuclear grade. There was no significant difference in cancer-specific survival between patients with papillary and chromophobe RCC (p = 0.918). The 1997 TNM stage, tumor size, presence of a sarcomatoid component, and nuclear grade were significantly associated with death from clear cell, papillary, and chromophobe RCC. Histologic tumor necrosis was significantly associated with death from clear cell and chromophobe RCC, but not with death from papillary RCC. Our results demonstrate that there are significant differences in outcome and associations with outcome for the different histologic subtypes of RCC, highlighting the need for accurate subtyping.

Adenocarcinoma, Clear Cell↗